Iodoform Ribbon Gauze

dental infections

Encephalopathy has been associated with the use of bismuth subnitrate and Iodoform Ribbon Gauze paste (BIPP) for the packing of wound cavities after ear, nose, and throat, oral, and maxillofacial surgery,1,2 although there is some debate as to whether the bismuth or the Iodoform Ribbon Gauze component is responsible.1-3 However, encephalopathy has been reported after application of Iodoform Ribbon Gauze gauze without bismuth.4,5 CNS toxicity due to both iodine and bismuth has been reported6 in an 86-year-old woman from an intra-oral plug of BIPP following partial maxillectomy. Five days after surgery the patient started to experience loss of appetite and lightheadedness, and by day 11 was suffering from fainting episodes, confusion, and paranoid ideation and was becoming increasingly aggressive. On day 14 the BIPP pack was removed; 7 days later the patient’s condition improved and when discharged 5 days later she was alert and cooperative